Pelicano Module 2 Cardiovascular Flashcards
Hypertension
Defined as B/P higher than 140/90. Physical inactivity causes blood to be stagnant and allow gunk build up. stress raises B/P, and can cause vasoconstriction.
Risk factors in Circulatory/Heart Diseases
Age, Gender, Ethnicity, Heredity, Smoking, Obesity, Physical Inactivity, Hypertension, Hyperlipidemia, Diabetes Mellitus, Stress, Metabolic Syndrome.
Classification of BP and stages of Hypertension
Normal = 120/80
Prehypertension = 120-139 / 80/89
Stage 1 = 140-159 / 90-99
Stage 2 = 160 + / 100 +
Common symptoms of Hypertension
Nose bleed. Headache. Damaged blood vessels
Treatment for hypertension
Lose weight, limit alcohol, stop smoking, LOW SODIUM DIET, exercise, always monitor B/P
Atherosclerosis
Yellowish plaques of cholesterol, lipids & cellular debris (from smoking), in the inner layers of the walls of the arteries. Lumen of the vessel narrows causing obstruction of blood flow.
Severity of disease is measured by degree of obstruction.
Risk Factors of Atherosclerosis (Same as HTN)
Age, Gender, Ethnicity, Heredity, Smoking, Obesity, Physical Inactivity, Hypertension, Hyperlipidemia, Diabetes Mellitus, Stress, Metabolic Syndrome.
Coronary Heart Disease
Conditions that obstruct blood flow in the coronary arteries (supply blood to the heart).
Primary cause is atherosclerosis.
When flow of blood & oxygen is cut off cells will die.
Most common diseases resulting from this are angina & myocardial infarction.
Angina
Chest pain
The heart is screaming out in pain.
This is a warning that there is not enough oxygen
Angina Pectoris
Atherosclerosis of the coronary arteries is the most common cause (90%) can also be caused by a thromboemolism.
Cause of Angina Pectoris
decreased flow of blood to the myocardium (ischemia) leading to oxygen and chest pain(angina)
triggered by cold, exercise. (activity increases metabolic demand) & stress
Signs and Symptoms of Angina Pectoris
PAIN, heaviness or tightness in substernal area of chest or precordial(across the heart), spasmostic(fluctuating) severe discomfort
Pain starts to radiate to neck, arms, shoulders, or jaw
SOB, pallor, anxiety & fear
How to relieve pain of Angina Pectoris
Rest and Nitroglycerin. (Vasodilator)
Can take nitroglycerin every 5 min x 3 if pain doesn’t go away go to the hospital
Beta Blockers / Calcium channel blockers (after diagnosed)
Medical Procedures used to treat Coronary Artery constriction
CABG ( Coronary Artery Bypass Graft )
PTCA (Porcutaneous Transliminal Coronary Angioplasty) Balloon
Coronary Artery Stent ( Wire mesh that is expandable keeping artery open )
Nursing Care for Angina
Assess chest pain, VS, O2 saturation, cardiac monitoring.
Semi-fowlers with O2 therapy as ordered
Administer medications - Check B/P and HR
Myocardial Infarction
permanent lack of oxygen , ischemia (large area) , Necrosis ( smaller part)
Occlusion of one of the coronary arteries or its branches by clot or sclerotic condition; the part of the heat that loses the blood supply dis (necrosis of the area)
Mi usually affects the left ventricle because it is the workhorse of the heart & demands more oxygen
Signs and Symptoms of Myocardial Infarction
May be asymptomatic : silent MI
Pain - substernal or precordial - more severe than angina, crushing, vise - like, radiates to shoulder, arm, neck, jaw, prolonged, intense. Not relived by rest or Nitroglycerin
SOB, pallor cold/clammy skin, diaphoresis, anxiety, nausea/vomiting, decreased B/P, tachycardia, weak pulse, increased temp.
Valsaluer Maneuver
Bear down - need to prevent to patient from doing this. Making sure stool is soft
Nursing care for Myocardial Infarction
Medications, Morphine (decreases pain)
Heparin
Angioplatelet agents ASA
Stool softeners
Avoid fatigue, O2 therapy, Decreased fat/NA
ANTI EMBOLISM Stockings (prevent clot formation)
Rheumatic heart disease
Results from inflammation of the heart. Zithromax used often
Caused by inadequately treated strep infection
inflammation of cardiac tissue, CNS, joints, and skin
Causes necrosis on valve
Develops vegetative growth
Signs and Symptoms of Rheumatic Heart disease
Fever, joint and abdominal pain, chest pain/discomfort. Tachycardia/SOB, lethargy and fatigue, Valve problem MAY HEAR SWISHING SOUND (murmur)
Treatment of Rheumatic Heart disease
Rapid treatment of strep infection
bedrest when accurately ill (carditis present) - gradually increase activity
Manage joint pain use NSAIDS decreases inflammation of the heart
MAY NEED VALVE REPLACEMENT IF DAMAGE
Pericarditis
Inflammation of the membranous sac surrounding the heart.
Associated with bacterial, viral, and fungal infection.
NEED TO DECREASE INFLAMMATION
OUTER LAYER GETS INFLAMED
S/S of Pericarditis
Chest pain radiating to back or neck may be aggravated by deep breathing, laying down, coughing, movement, swallowing or supine position. Pericardial friction rub, fever, chills, dyspnea, tachycardia, arrhythmia
Treatment of Pericarditis
Analgesics, VS, O2, IVF, Anti inflammatories.
Pericardiocenesis to remove fluid
Endocarditis
Inflammation or infection of inner membranous lining of heart, especially the valves
(Vegetative emboli)
Myocarditis
Inflammation of the myocardium
Caused by rheumatic heart disease. virus, or bacteria.
May develop into cardiomyopathy
Cardio myopathy
Failure of the heart to PUMP
Group of heart diseases that affects its structure and function.
Causes are unknown - viral bacterial alcohol drugs radiation.
MAY NEED A/CD AUTOMATIC CARDIAC DEFRIBULATOR
Valvular Heart disease
Valves do not open or close properly due to stenosis (thickening of valve tissue causing narrowing) or insufficiency.
MAY NEED VALVE REPLACEMENT
Peripheral Vascular System
Arterial disorders ( disorders occur when circulation to upper & lower extremities is compromised)
Arteriosclerosis and Athersclerosis of the peripheral arteries results in decreased blood supply; this is an underlying problem in this disease
PVP/PAD
Peripheral Vascular Disease / Peripheral Arterial Disease
Usually effects lower extremities
INTERMITTENT CLAUDICATION - pain with activity due to ischemia - described as aching or cramping
Arterial Aneurysm
Enlarged dilated portion of an artery.
Can occur in lower extremities, thoracic/abdominal aorta.
Buergers Disease
AKA Thromboangitis Obliterans occlusive vascular condition in which small/medium arteries become inflammed & thrombotic
OCCURS IN SMOKERS MALE 25-40
Raynauds Disease
Intermittent arterial spasms/ischemia attacks especially fingers, ears, toes and nose.
Affects more WOMEN 20-40
Cause unknown Chronic cold hands and feet. Cyanosis & pain
may result in ulcerations
Venous Disorders
Occurs when blood flow is interrupted in returning from tissues to heart ‘Thrombophlebitis / Varicose Veins
Slow heart rate, usually defined as fewer than 60 beats per minute
Bradycardia
Rapid heart rate, usually defined as greater than 100 beats per minute
Tachycardia
Abnormal thickening and hardening of the arterial walls caused by fat and fibrin deposits (plaques of cholesterol and lipids
Atherosclerosis
Obstruction of a blood vessel with a blood clot transported through the blood stream
Thromboembolism
A sound heard on auscultation; in the heart, it indicates turbulent blood flow across heart valves
Murmur
Abnormal thickening and hardening of the arterial walls ( thickening and lost of elasticity + calcification of arterial wall )
Arteriosclerosis
The amount of blood in the left ventricle at the end of diastole; the pressure generated at the end of the diastole
Preload (Stretch Ventricle)
Disturbance of rhythm, arrhythmia
Dysrhythmia
Study of the movement of blood and the forces that affect it
Hemodynamics
A heartbeat that is strong, rapid, or irregular, enough to have the person realize it
Palpitation
Fainting
Syncope
The amount of resistance the left ventricle must generate to open the aortic valve
Afterload (Must eject blood again)
Backward flow
Regurgitation
An area of ischemic necrosis caused by disruption of circulation
Infarct
Passage of blood through vessels of an organ
Perfusion
An ambulatory ECG that provides continuous monitoring
Holter Monitor
A transducer is used that picks up SOUND WAVES and converts them to electrical impulses
Echo-cardiogram
A high resolution, 3D image os the heart, cardiac tissue is imaged WITHOUT LUNG OR BONE INTERFACE
MRI
An exercise tolerance test that is a recording of an individuals cardiovascular response during a measured exercise challenge
Stress test
Study of electrical activity in the heart
ECG
A procedure in which a catheter is advanced into the heart chambers or coronary arteries under fluoroscopy
Cardiac catherization
Test that may determine pressures in the RA, RV, and pulmonary artery
Cardiac catherization
Electrodes place on the surface of the skin pick up the electrical impulses of the heart
ECG
The patient ambulates in a treadmill or stationary bicycle while connected to a monitor
Stress test
Heart sonogram that is a visualization and recording of the size, shape, position, and behavior of the hearts internal structure
Echo-cardiogram
A test that determines the body’s ability to maintain the acid-base balance
Arterial blood gases
A test used to measure a blood lipid that is produced by liver and is used to form bile salts for the digestion of fats and to form some hormones
Cholesterol
In addition to LDL cholesterol, these lipids are a major contributor to coronary artery disease
Triglycerides
Feeling of impending doom
Anxiety
Lack of oxygen to the myocardium
Pain
Decreased Cardiac Output
dysrrhythmia
Dependent edema, Increased central venous pressure, Jugular vein distention, Abdominal engorgement are all examples of CHF in what side
Right side
Decreased B/P readings, Anxious, pale, and tachycardiac, Crackles, wheezes, dyspnea, and cough are all examples of CHF in what side
Left side
When the patient has right sided heart failure, there is a congestion of blood within the
Peripheral Vascular System
Cardiomegally
Enalrged heart
4 common symptoms of Heart failure
Cardiac output
Peripheral Edema
Ascites
Lung congestion
(T/F) Drug therapy is aimed at improving cardiac output
True
(T/F) Pulmonary edema represents a medical emergency
True
(T/F) Pulmonary edema is a complication of left sided failure
True
TWO of the MAIN medications used to treat CHF
Digoxin
Lasix (Diuretic)
What type of diet is prescribed for a patient with CHF
LOW SODIUM, low fat
Orthopnea
Breathing is only capable when sitting up
Headaches and nose bleeds are the most common signs of
Hypertension
Decreases blood flow to the myocardium, causing decreased oxygen
Ischemia
Wire that expands to keep artery open
Coronary Artery Stent
“Balloon procedure, Angioplasty”
PTCA
Best position to put someone with Angina
Semi-fowlers
Where heart failure usually begins, DECREASED CARDIAC OUTPUT, shortness of breath, dyspnea, pink frothy sputum
Left ventricular failure
Affects liver, ascites, distended jugular veins
Right ventricular failure
When blood is a viscous red fluid that contains RBCs, WBCs, and platelets suspended in a light yellow fluid
Blood Dyscrasias
Decreased RBCs
Anemia
What does ascorbic acid and Vitamin C have to do with iron
Helps absorb the iron better
Decreased circulation blood because of a hemorrhage
Hypovolemic shock
Abnormal crescent shaped RBS
Sickle Cell
Immunological problem resulting in decreased bone marrow function
Aplastic Anemia
Severe reduction in # of total granulocytes
Agranulocytosis
Excess WBCs accumulate in bone marrow & lymph nodes, Not producing MATURE WBC
Leukemia
Most curable of all cancers, linked to Epstein-Carr virus, PRESENCE OF REED-STERNBERG CELLS
Hodgkins Disease
